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Yet, long-term results that compare this procedure with established methods are lacking. The aim of this study was to report and compare long-term results of ACL reconstruction using QTB autografts versus bone\u2013patellar tendon\u2013bone (BPTB) autografts, both anchored using a hardware-free press-fit fixation technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>60 athletes (Tegner score \u22656) with primary ACL rupture were prospectively randomized into two groups. 56 patients were evaluated after a mean duration of 12.2\u2009\u00b1\u20091.9\u00a0months (range 10\u201314) and 43 patients after 10.3\u2009\u00b1\u20090.2\u00a0years (range 10\u201311).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On final follow-up, 90% of patients scored very good and good results in the functional Lysholm score (mean 99\u2009\u00b1\u20097.1, range 74\u2013100 points). Normal or almost normal IKDC score was reported by 84% of the patients (mean 97\u2009\u00b1\u20099.5, range 60\u2013100 points). The activity level decreased in the Tegner score from median of 7 before injury to 6 after 10\u00a0years. The KT-1000 arthrometer showed a difference in the anterior translation of less than 3\u00a0mm (mean 1.0\u2009\u00b1\u20091.2, range \u2212\u20091 to 5\u00a0mm) in 91% of the patients. Significant degeneration was radiologically detected in one patient per group. No tunnel widening was seen in any patient. Up to 97% of all patients were satisfied with the operative procedure. No significant differences were found in the mentioned parameters between the two groups and also in comparison with the 1-year results. The only significant difference was in the donor site morbidity. Significantly more patients in the BPTB group had complaints during kneeling both at 1 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and 10\u00a0years (<jats:italic>p<\/jats:italic>\u2009=\u20090.019). Squatting was also subjectively more problematic in the BPTB group than in the QTB group both after 1 (<jats:italic>p<\/jats:italic>\u2009=\u20090.003) and 10\u00a0years (<jats:italic>p<\/jats:italic>\u2009=\u20090.046).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study shows equally good functional, clinical and radiological long-term results for both hardware-free methods of ACL reconstruction. These results clinically confirm the safety of press-fit anchoring after 10\u00a0years. The failure rate in this study was very low, with only one re-rupture in 10\u00a0years. The increased donor site morbidity when using the BPTB autograft compared to the QTB autograft supports already reported data. It was also seen in this study for the implant-free press-fit techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>Prospective and randomized, level of evidence 2.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00402-020-03508-1","type":"journal-article","created":{"date-parts":[[2020,6,5]],"date-time":"2020-06-05T06:03:06Z","timestamp":1591336986000},"page":"1465-1474","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["Quadriceps tendon vs. patellar tendon autograft for ACL reconstruction using a hardware-free press-fit fixation technique: comparable stability, function and return-to-sport level but less donor site morbidity in athletes after 10\u00a0years"],"prefix":"10.1007","volume":"140","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6548-5606","authenticated-orcid":false,"given":"Alexander","family":"Bari\u00e9","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Sprinckstub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Huber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayham","family":"Jaber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,6,5]]},"reference":[{"issue":"7","key":"3508_CR1","doi-asserted-by":"publisher","first-page":"1699","DOI":"10.1177\/0363546516634325","volume":"44","author":"TL Sanders","year":"2016","unstructured":"Sanders TL, Kremers HM, Bryan AJ, Fruth KM, Larson DR, Pareek A, Levy BA, Stuart MJ, Dahm DL, Krych AJ (2016) Is anterior cruciate ligament reconstruction effective in preventing secondary meniscal tears and osteoarthritis? 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